Faculty of Medicine, Ballarat Health Services, Ballarat, Victoria, Australia.
School of Medicine, Deakin University, Geelong, Victoria, Australia.
Intern Med J. 2022 Apr;52(4):574-580. doi: 10.1111/imj.15073.
Stroke and diabetes mellitus (DM) are significant interrelated healthcare issues but there is a dearth of data on the prevalence of DM among Australia's regional stroke population.
We aimed to determine the prevalence of DM in stroke patients at a large regional centre, including subanalyses on stroke subtypes, glycaemic control and renal function in ischaemic stroke (IS).
We conducted a retrospective analysis of all patients (n = 323) with IS or transient ischaemic attack (TIA) admitted to Ballarat Base Hospital from January 2015 to December 2016. Demographic data, cardiovascular risk factors, aetiology/territory of IS, pre-morbid DM status, indicators of glycaemic control and renal impairment were recorded.
DM was present in 28.5% of IS and TIA patients, including 4% being newly diagnosed. Among diabetic IS patients, 45.3% had poor glycaemic control (HbA1c ≥7.0%) while 16% had moderate to severe renal impairment (estimated glomerular filtration rate of <30). The majority of IS were partial anterior circulation stroke (53.4%) and cardioembolism was the commonest mechanism (43.5%). We found no significant association between DM and a specific stroke location or mechanism.
Almost one-third of IS/TIA patients had DM, with a significant proportion showing poor glycaemic control. The DM prevalence in our cohort was comparable with reported rates from other developed countries. Although we found no association between DM and a particular stroke type or mechanism, it is likely a reflection of our cohort size. Our study demonstrated that DM, as a significant risk factor in IS, warrants early detection and better management strategies.
中风和糖尿病（DM）是相互关联的重要医疗保健问题，但关于澳大利亚地区中风人群中 DM 的患病率数据却很少。
我们旨在确定大型地区中心中风患者中 DM 的患病率，包括对缺血性中风（IS）中风亚型、血糖控制和肾功能的亚分析。
我们对 2015 年 1 月至 2016 年 12 月期间入住巴拉瑞特基地医院的所有 IS 或短暂性脑缺血发作（TIA）患者（n=323）进行了回顾性分析。记录了人口统计学数据、心血管危险因素、IS 的病因/部位、中风前 DM 状态、血糖控制和肾功能损害的指标。
IS 和 TIA 患者中 28.5%存在 DM，其中 4%为新诊断。在糖尿病 IS 患者中，45.3%血糖控制不佳（HbA1c≥7.0%），16%存在中重度肾功能损害（估算肾小球滤过率<30）。大多数 IS 为部分前循环中风（53.4%），心源性栓塞是最常见的机制（43.5%）。我们未发现 DM 与特定中风部位或机制之间存在显著相关性。
近三分之一的 IS/TIA 患者患有 DM，其中很大一部分患者血糖控制不佳。我们队列中的 DM 患病率与其他发达国家的报告率相当。尽管我们未发现 DM 与特定中风类型或机制之间存在关联，但这可能反映了我们队列的规模。我们的研究表明，DM 作为 IS 的一个重要危险因素，需要早期发现和更好的管理策略。
